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Critically Ill Exam 1 > Fluids And Electrolytes > Flashcards

Fluids And Electrolytes Flashcards

1
Q

What is the normal range for calcium?

A

8.6-10.2

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2
Q

What can lead to falsely low calcium levels?

A

Hypoalbuminemia

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3
Q

What is the corrected calcium equation?

A

Total calcium + [0.8 x (4-albumin)]

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4
Q

When is hypocalcemia considered severe?

A

<7.5 mg/dL

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5
Q

When are oral calcium replacements typically used?

A

Chronically to maintain calcium stores

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6
Q

What should you avoid giving with calcium?

A

Phosphate

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7
Q

For severe hypocalcemia, what is used for treatment?

A

1 g calcium chloride OR 3 g calcium gluconate IV, then slow continuous infusion

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8
Q

What is used for the treatment of hypercalcemia? 3

A
  1. IV hydration
  2. IV diuretics
  3. Hemodialysis
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9
Q

What type of calcium is a vesicant?

A

Calcium chloride

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10
Q

What is the normal range of Potassium?

A

3.5-5

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11
Q

What is most commonly used for the treatment of hypokalemia?

A

Potassium chloride

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12
Q

What are 3 temporary interventions for the treatment of hyperkalemia?

A
  1. Albuterol nebulizer treatments
  2. Regular insulin plus IV dextrose 25g
  3. Sodium bicarbonate
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13
Q

What should not be used to treat hyperkalemia if the patient has renal failure?

A

IV diuretics

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14
Q

What is the normal range for phosphate?

A

2.7-4.5

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15
Q

When is hypophosphatemia considered severe?

A

<1.5

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16
Q

What is used to treat mild and asymptomatic hypophosphatemia?

A

Oral phosphate replacement

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17
Q

What is used to treat significant or symptomatic hypophosphatemia?

A

IV phosphate replacement: sodium phosphate or potassium phosphate

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18
Q

What dose of IV phosphate in mmol, can be used to treat hypophosphatemia?

A

15 mmol

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19
Q

What dose in mmol can be used to treat severe hypophosphatemia?

A

30 mmol

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20
Q

When is calciphylaxis seen?

A

When calcium/phosphate product exceeds 55-60

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21
Q

What is not used for acute management of phosphate?

A

Phosphate binders

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22
Q

What is the normal range of magnesium?

A

1.5-2.4

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23
Q

What is preferred for magnesium replacement?

A

IV magnesium sulfate

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24
Q

When fluid switches from plasma to interstitial (extra vascular) fluid

A

Third spacing

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25
What is the normal serum osmolarity?
275-300 mOsm/kg
26
What is the range for isotonic fluid?
250-375
27
What fluid does not change after infusing it into the body?
Normal saline
28
What can the use of dextrose cause? Why?
Excessive third spacing and hyponatremia. Dextrose gets metabolized and leaves nothing behind but water
29
What is the property of normal saline?
Purely **isotonic**
30
What is the breakdown of Na and Cl in normal saline?
154 mEq Na, 154 mEq Cl
31
What are the properties of 1/2 NS?
Purely hypotonic
32
What is the breakdown of Na and Cl in 1/2 NS?
77 mEq Na, 77 mEq Cl
33
What is the mOsm/L for D5W?
252 mOsm/L
34
What are the properties of D5W?
Begins **isotonic**, then becomes **hypotonic**
35
What is the mOsm/L of D5NS?
560 mOsm/L
36
What are properties of D5NS?
Purely isotonic
37
What is the mOsm/L for D5 1/2 NS?
406 mOsm/L
38
What are the properties of D5 1/2 NS?
Begins **isotonic**, then becomes **hypotonic**
39
What is the mOsml/L for Lactated ringers?
273 mOsm/L
40
What are the properties of LR?
Purely isotonic
41
What is the mOsm/L for 3% NaCl?
1027 mOsm/L
42
What are the properties of 3% NaCl?
Purely hypertonic
43
What should you use when giving 3% NaCl?
A central line
44
What is used as the “standard” colloid?
Albumin
45
What albumin concentration should be used when a patient is hypotensive?
Albumin 5%
46
What albumin concentration raises oncotic pressure in the vasculature and draws fluids from the periphery into the vasculature?
Albumin 25%
47
What albumin concentration delivers fluids that go and remain in the vasculature?
Albumin 5%
48
What is the normal chloride range?
97-107 mEq/L
49
What is hyponatremia usually associated with?
Decreased serum osmolality
50
What can hyponatremia cause?
Neurological effects
51
When treating hyponatremia, you should not increase plasma sodium faster than _________.
6-12 mEq/L/day
52
If patients are acutely symptomatic from hyponatremia, what is the maximum increase?
1-2 mEq/L/hr
53
What fluid type usually presents with hyponatremia?
Hypervolemia
54
What fluid status usually presents with hypernatreamia?
Hypovolemia
55
How much sodium is in LR?
130 mEq
56
What is another common cause of hyponatremia?
SIADH
57
How would you treat hyponatremia?
By stopping or changing the unnecessary or inappropriate fluid
58
How would you treat hypernatremia?
Adding fluids (iso/hypotonic)
59
What is another common cause of hypernatremia?
Diabetes insipidus
60
What can hyperglycemia cause in regards to sodium?
Pseudohyponatremia
61
For each 100 mg/dL of glucose above normal, plasma sodium decreases by ___ mmol/L
1.6
62
What does SIADH stand for?
Secretion of inappropriate anti diuretic hormone
63
What are 5 drugs that can cause SIADH?
1. SSRIs 2. NSAIDs 3. Opioids 4. Antidepressants 5. Antipsychotics
64
What are the 2 methods for treating SIADH?
1. Fluid restriction to <1500 mL/day 2. Low dose loop Diuretics + oral NaCl @ doses of 4-16 g/day
65
Disease consisting of decreased secretion of anti diuretic hormone leading to decreased retention of water at the distal tubule
Diabetes Insipidus
66
What are 3 ways to treat diabetes insipidus?
1. Hypotonic solutions 2. Vasopressin analogs 3. Desmopressin 1-2 mcg IV or SQ BID
67
What is another option to treat diabetes insipidus?
Vasopressin infusion
68
How much potassium is in Kphos?
22 mEq
69
How much sodium is in Naphos?
20 mEq

Critically Ill Exam 1 (7 decks)

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